The internet's only blog on Health Insurance

June 26, 2007

The number of American adults without health insurance has jumped by 2 million, according to the U.S. Centers for Disease Control and Prevention. Almost 44 million Americans — equal to the combined population of 24 states — are listed as uninsured in 2006, a 6 percent jump from the previous year.

There are few things that Gov. Edward G. Rendell and I agree on. The fact that they have too many residents without health insurance coverage is one of them. Between 750,000 and 900,000 adults are uninsured. They are part of the growing tide of working men and women who do not have health coverage.

Rendell's answer for the uninsured is predictable: Raise somebody's taxes and get the government more involved in running health insurance programs.

"More taxes, more government involvement" is the liberal mantra for whatever ails us when it comes to folks like Ed Rendell and Hillary Clinton. The key ingredient in Rendell's "Prescription for Pennsylvania" is to impose a tax on employers who don't provide health coverage for workers.

The problem with raising taxes on employers is that it will force some of them out of business because they can't afford to insure workers. That will put more workers in the ranks of the uninsured. Tax-and-spend liberals like Rendell never think through their knee-jerk "solutions" to problems.

Inexplicably, Rendell waited until his fifth year in office before addressing the problem of uninsured workers. Didn't these people need health coverage in the first four years of Rendell's tenure?

Rendell has been unwilling so far to address other factors that contribute to the uninsured such as malpractice rates, insurance fraud, bureaucratic waste and tort reform. Rendell's Insurance Department might as well be a PR/Marketing wing for the big insurance lobby. (Didn't Rendell's insurance secretary just take a job with the insurance industry?). Instead of looking out for consumers, Rendell's Insurance Department has been a little too cozy with big insurance and has looked the other way while insurance companies have raised their rates astronomically.

And nobody has been able to provide a satisfactory explanation of how non-profit insurance carriers in the state are sitting on billions of dollars in profits. Sounds to me that the Blues are charging way too much for premiums and not paying out enough in claims.

And unlike Dr. Rendell's prescription for solving the health insurance problem (getting government more involved in medicine), the Wonderling and Schroder bills would not cost taxpayers a thing.

June 24, 2007

Women and health care

As California moves toward adopting the most comprehensive health-care reform in the nation, the needs of half the state's population -- women -- must be taken into account.

A range of obstacles -- economic, social and logistical -- make it difficult for women to gain access to a full range of health services.

As the debate proceeds, lawmakers should remind themselves that women are the major consumers of health care -- because of their reproductive needs and because they live longer, with higher rates of chronic illness than men.

It's an uncomfortable truth that the wages of women still lag considerably behind men. The median income for women in California is about $37,000 -- compared to $45,000 for men. In fact, two-thirds of the 2.5 million uninsured women in California are from low-income backgrounds.

The ability of women and their families just to afford health coverage -- at a time of rising costs -- is one of the main issues that must be addressed in any health reform plan devised in Sacramento.

For health-care "reform" to be meaningful for most women in California, premiums need to be affordable. Women will need protection from high out-of-pocket costs from co-pays and deductibles. On average, high deductible health plans are 25 percent less than for traditional plans. But these plans often demand unaffordable out-of-pocket payments for routine events, such as having a baby.

Women are also at greater risk of losing health insurance. One in 5 women in California receives health coverage as a "dependent" through her husband's employment. That coverage is threatened when women are widowed, get divorced -- or when their spouses lose their jobs.

June 22, 2007

The California Assembly voted 47-32 in favor of Assembly Bill 8, a new bill that takes aim at Health Care reform. The bill is intended to help nearly 70 percent of uninsured people by making health care more available.

However, despite the efforts of the new bill, young people between the ages of 19 and 29, mostly students, are still the largest uninsured group in the United States and that number is growing.

There are 13.7 million young adults who have no health coverage. That number is up 2.5 million since 2000.

More than half of those uninsured have reported that they went without treatment when it was needed because they couldn't afford the cost. This has left many young people unsure of what to do.

"There are many reasons health care is so expensive and no easy answer," said Gail Love, California State University-Fullerton professor of communications who also specializes in health, in an e-mail interview. "Americans feel the latest in medical advances and technology is an entitlement, however these are extremely expensive."

The delivery of health care is also expensive, Love said, instead of seeing a physician for a problem many of those who are uninsured end up in emergency rooms. She continued that emergency room treatment is the most expensive way to receive care.

The passing of Assembly Bill 8, AB 8, includes ways to expand public health programs, cut costs of existing programs and improve the quality of private health care, according to the press release.

Fabian Nunez, a speaker who wrote the bill, intended for it to help those who couldn't afford care, which includes children.

However, the bill does nothing for college-aged people who, after 17, find themselves unqualified for their parents' plans and unable to find cheap health care. Medicaid and the State Children's Health Insurance Program have their cut-off point at age 19.

Health insurance premiums have risen 87 percent over the past six years while wages have only increased 23 percent, putting pressure on minimum wage workers such as college students, according to the Center for American Progress.

June 20, 2007

ABC Demands ‘Answers’ on U.S. Health Insurance

On Monday’s "Good Morning America," the ABC program shifted into full advocacy mode as anchor Chris Cuomo investigated the health insurance industry. A week after the network promoted Michael Moore’s new documentary "Sicko" for over 21 minutes, co-host Diane Sawyer announced that, regarding health care, the program was demanding "some answers" with a new segment. According to Sawyer, the series is "for you, for all of us." At the close of the report, the ABC anchor even pleaded with the audience for examples of nefarious health care companies:

Diane Sawyer: "...If you have an insurance company policy, a question that you want to raise, you want us to tackle something that you think the insurance companies are doing, you write to us. You let us know about it. ABCNews.com. We are on the case."

And while Cuomo was "on the case" of a woman who had difficulty getting her insurance company to approve a much needed eye surgery, there has been no similar look at Canadian horror stories where government run health care made one woman with breast cancer wait three months for radiation treatment.

A report by the Canadian Fraser Institute found that the average wait time in that country to see a general practitioner was 17.7 weeks. One such incident found a woman waiting over three months to receive radiation therapy for breast cancer:

A similar lawsuit was filed in Quebec on behalf of 10,000 women with breast cancer who were forced into long waits for radiation therapy. Anahit Cilinger was one such patient. After having a lymph node removed in October 1999, she was put on a waiting list for radiation therapy. Three months later and with no end to the waiting in sight, she traveled to her native Turkey and paid $12,000 for the treatment.

June 18, 2007

California Health Insurance Coverage Is Becoming Less Affordable

For many Californians in the individual and small-group markets, sky-rocketing healthcare costs mean benefit drop-offs or spiking premiums, a new study says.

Some healthcare reform advocates -- including President Bush -- have suggested moving all Americans out of employer-based health insurance and into plans purchased on the individual market, arguing that more choices for consumers will lead to lower premiums.

In California, individual insurance premiums do seem to be increasing at a slower rate than small-group market premiums, according to the study appearing Thursday on the Web site of the journal Health Affairs.

But the trade-off for lower premiums is steep reductions in benefits, the study found.

Between 2003 and 2006, premiums for employees of small businesses rose 53 percent from $250 to $382, while premiums in the individual market increased only 23 percent to $259.

However, individual-market policies paid 75 percent of medical costs on average in 2003 but only 55 percent in 2006. In contrast, small-group policies retained their actuarial value, paying for roughly 83 percent of medical expenses across the period.

What's more, individual-market enrollees faced much higher cost-sharing in 2006 than their small-group-market counterparts. The average deductible in the individual market was $2,136, more than six times the size of the average small-group-market deductible of $348.

June 15, 2007

Graduates’ next exam: insurance

While Heather McManus crammed for her last batch of college finals this week, she was also studying her health insurance options.

McManus turned 22 on Wednesday and joined the ranks of the 6.5 million uninsured Californians because she no longer qualified for her parents’ health coverage.

“It’s like, ‘Happy Birthday, now you have no health insurance,’ ” said the Cal Poly senior, who will graduate Saturday.

McManus falls in the age group most likely to be uninsured: young adults. About one-third of Californians between ages 19 and 29 are uninsured, according to the California Health Interview Survey.

The high cost of health insurance adds pressure to new college graduates looking for jobs. Two of every five college graduates will become uninsured in the year after leaving school, according to the Commonwealth Fund, a nonpartisan think tank.

McManus, of Livermore, never thought much about health insurance. She always had her parents’ coverage, and during college, she received care at the Cal Poly student health center. After Saturday, both safety nets will be gone.

About 100 million insurance customers in the U.S. have access to Web-based tools, but companies don't have an estimate of how widely they are used. Insurers hope to at least double the technology's reach by the end of next year.

Aetna chief executive Ronald Williams says the change is as revolutionary to health care as the introduction of the ATM card was to banking in the 1980s.

But privacy advocates say there's no guarantee the records will be safe from hackers. Some worry patients may refuse to disclose some illnesses to their doctors to keep documents out of databases.

"As a former nurse, I know that back in the 1980s, patients who were alcoholics did not want to have paper records," said Sue Blevins, president of the Institute for Health Freedom "They just didn't want people to know & That could affect the quality of their care."

Aetna, which offers personal health records to its customers, says security procedures include a member login and an online registration Web site with secure sign-ons. In addition, customers can restrict elements of their records from being shared among health practitioners.

Aetna said personal health records are protected by the same security technology that is used for online banking.

Personal health records, which are available through insurers Aetna, Blue Cross Blue Shield and others, are intended to help doctors and patients track medications and treatments.

The technology allows doctors to record test results, immunizations, prescriptions and other medical information into an online database that can be accessed by patients, the insurer and other physicians if needed. Patients can also add details about over-the-counter medications, plans of care, family health histories and other information.

June 11, 2007

Winning at the Health Insurance Game

Are Americans paying too much for health insurance? While health care costs continue to skyrocket, more and more consumers are finding affordable health insurance solutions online.

According to a study, worker's health insurance premiums have increased 84 percent since 2000, while wages have increased only 20 percent. The increased cost of health insurance is pushing many employers to drop traditional employee coverage or shift more costs to workers. Workers in turn are looking for new ways to affordably protect themselves and their families.

Consumers can find a number of online resources designed to explain their health insurance options. Web sites like Insuremyhealth.com help users learn more about their choices, find the plans best suited to their needs, and apply for coverage quickly and easily.

"To find health insurance solutions that work for them, consumers are thinking critically about their needs," adds a worker. "They're asking: Do I need maternity benefits? Unlimited coverage for prescription drugs? How much am I willing to pay for a doctor's visit or in case of hospitalization? Consumers want to see how their options stack up and find a health plan custom-fit to their needs."

June 09, 2007

Health Insurance Companies Easing Burden of High COBRA Costs

Senate Health Committee Chairman, Senator Kemp Hannon, announced a part of the recently adopted a new budget, which enables health insurance companies to carry individuals under their parent's policy to age 25, instead of age 19 for those who do not go to college and 23 for those who do.

The part of the bill, announced at a University Student Center during a June 1 press conference, will be a relief to many parents and young people facing extremely high COBRA costs when their child reaches the age of ineligibility under their plan, but is either still in school or searching for employment. The legislation also assists those young 20-somethings who are bearing the brunt of their own health insurance costs by enabling them to obtain health insurance coverage through their parents.

June 08, 2007

Kaiser Permanente Healthcare Insurance

Health insurance is an issue and need for everyone. There are, for people who can afford them, many choices. For those without resources, the choices are far more limited but, under some circumstances, a good plan may be available to impoverished people through various 'partnerships' with public agencies. No matter what your circumstances, choices need to be discovered, examined and evaluated - good decisions for you and your family need be made. This review is a summary of one of the more comprehensive choices now available in a number of states including California (where it began), Hawaii, Oregon, Ohio, Colorado and several others, Kaiser Permanente. My family and I have been a Kaiser patients ourselves for well over thirty years, our child and grandchildren were born there, my wife and I have had surgeries, gotten eyeglasses, multiple procedures and prescriptions as functions of our membership and I have actually been employed as a Provider with them (a Clinical Social Worker in Psychiatry) for the past seven years, so I have experienced this system of services both as a consumer as well as someone on the 'inside', a care provider. These comments reflect my aggregate understanding of Kaiser, it's values and drawbacks, who it works well for and who it doesn't and it's merits relative to other insurance choices. Should you find yourself in that seminally important choice making that important decision, it is my hope that this brief discourse will be of some help to you.

Firstly, on the notion if "Integration" of services.
Kaiser is described as being fully integrated. That means that any specialist you might need to see or any medically related service you might need - everything from an inoculation, to an outpatient visit to Emergency care, a routine check up with your own doctor (Kaiser refers to this person as your Primary Care Physician), intensive inpatient treatments or even surgeries, occupational and physical therapies are all provided by Kaiser staff who have access to each other's information and, consequently, fewer errors are apt to occur as they relate to poor communication between a number of private doctors. There are a few exceptions - for example, Kaiser does not maintain it's own Psychiatry or inpatient chemical dependency program beds, but contracts for them with local specialized hospitals and programs - but, by-in-large, your medical needs will be me by Kaiser staff and ordinarily at one location! The outpatient clinicians are where the hospitals (Medical Centers) are. It is convenient in this way.

Is Kaiser cheaper than other coverages?
No, it is not. Years ago, it marketed itself as being an economical health care system. No more. Now it markets itself as being the 'best' available health care system. However, even so, a range of plans are now available that offer everything from fully priced, all inclusive plans with minor co-pays and no deductibles to less expensive plans geared to the healthier among us which cost a lot less but require more payment upfront when used. This customization of plans is available both to employers who buy it for groups or to individuals seeking to self insure themselves and their families. You can select a plan that makes the most sense for you.

June 07, 2007

Shopping for health care

When Scott Fowler quit his job at Wal-Mart to make a living as a painting contractor, he left his medical insurance behind. He and his wife went without health coverage for years because they believed they couldn't afford premiums of $600 to $700 a month.

But in recent years the health insurance industry, after so long seeming indifferent to individual customers, has increasingly catered to them, said Gary Lauer, chief executive of EHealth, which operates an online insurance agency.

Dozens of new kinds of products -- including high-deductible coverage, policies with linked sav ings accounts and policies that limit coverage for prescription drugs or maternity care -- have been introduced, said David Olsen, senior vice president of insurer HealthNet.

That has resulted in a vibrant market with a greater number of affordable options, experts say.

That proved to be a lifesaver for Fowler, who again went shopping for health coverage after his dad died of heart failure three years ago. This time, he was able to se cure a good policy for about half the price of the quotes he had received years earlier.

A few months after the policy began, Fowler was diagnosed with the same heart problem that killed his father. He spent eight days in the hospital to fix the condition. Had he not been insured, Fowler says, he wouldn't have received the life-saving diagnosis because he never would have gone to the doctor in the first place.

"It was a real blessing," said Fowler, 38, who lives in California. "When I wasn't feeling well, I realized I had insurance, so I could go to the doctor. I can't even imagine how much that insurance policy saved me."

June 05, 2007

High deductibles a pain for some insured

When Nancy Warrington became pregnant five years ago, she quit her job to become a full-time mom. With that, she lost the family's employer-subsidized health benefits.

Shopping for individual health insurance on their own, Warrington and her husband, Todd, settled on a plan with a $2,500 annual deductible and a $335 monthly premium.

"We were just looking for something [with a premium] we could afford," said Warrington, 35. "The high deductible didn't even dawn on me."

The insurance was a mixed blessing. Although it covered Nancy's appendicitis, Todd's back injury and an assortment of other medical needs over the years, the annual deductible also saddled the San Diego couple with more than $10,000 in debt.

Their case illustrates a problem with high-deductible health plans, a fast-growing type of coverage now held by about 10 million people in the U.S. The plans, with annual deductibles of $1,000 or higher and monthly premiums that can be less than $100, are a good fit for relatively healthy people with some financial means, most experts agree. The median annual income of those using high-deductible plans is about $75,000, according to a recent federal report.

The plans also are popular with young people who don't expect to run up significant medical bills.

Although the lower premiums make the plans attractive, cash-strapped families like the Warringtons run the risk of being unable to afford the deductibles, critics of the plans say.

Such consumers might forgo needed medical treatments to avoid running up out-of-pocket bills — possibly threatening their physical well-being, critics say. For these and other reasons, such plans are far from a desirable solution for the nation's approximately 47 million uninsured, they say.

June 03, 2007

Health insurance regulation proposed

A bill authored by Assemblyman Dave Jones, D-Sacramento, would require state regulators to approve increases in premiums, co-payments and deductibles proposed by insurers.

Gov. Arnold Schwarzenegger's health care reform proposal would require all Californians to obtain health insurance. As part of the governor's plan to control the costs of coverage, insurers would have to spend at least 85 percent of all premium dollars on medical care.

But a number of consumer and labor groups say the governor's plan doesn't go far enough to control costs. Californians who do not receive coverage through an employer or qualify for government subsidies would be required to purchase individual insurance. Rates for such coverage have been far outpacing inflation for years.

Jones' bill faces stiff opposition from the insurance industry. It needs enough votes to move out of the Assembly Appropriations Committee to stay alive.

"This is the big showdown," said Jerry Flanagan, health care advocate for the Foundation for Taxpayer and Consumer Rights, a consumer group supporting the bill. "The insurers want to kill it ... because the cost savings are huge for California consumers and they don't want that fact to be public."